玻璃体切割手术治疗化脓性眼内炎

目的 观察玻璃体切割手术治疗化脓性眼内炎的疗效。方法 对1999年6月～2003年2月在我院行玻璃体切割术的14例(14只眼)化脓性眼内炎患者进行回顾性分析。除眼内异物外，其余患者临床诊断化脓性眼内炎后均先采用保守治疗，密切观察1～2天无好转而行玻璃体切割手术。眼内炎的原因：眼球穿通伤13只眼，青光眼术后晚期滤过泡感染1只眼。玻璃体切割手术前先抽取前房及玻璃体腔内液体涂片及培养。采用标准三通道闭合式玻璃体切割手术，7只眼因前房积脓及晶状体前大量渗出和3只眼外伤性白内障影响手术而同时切除晶状体，8只联合巩膜环扎。缝合巩膜切口后玻璃体腔内注射罗氏芬2．5mg及地塞米松0．4mg。术后全身继续使用抗生素及激素1周。术后平均随访14．8个月(2～24个月)．结果 14只眼中术后视力提高12只眼(85．7％)，眼球保留13只眼(92．6％)。5只眼培养阳性。术后玻璃体腔内少量出血2只眼，无其它手术并发症。结论 玻璃体切割手术联合眼内注射抗生素治疗化脓性眼内炎疗效可靠。只要手术时机选择适当，大多数患者能保住眼球，恢复有用视力。     

29例感染性眼内炎患者病因及临床治疗效果分析

目的探讨感染性眼内炎患者的致病因素和临床治疗效果。方法回顾性分析安徽省立医院2013年1月至2014年6月收治的29例(29只眼)感染性眼内炎患者,分析其致病原因、治疗方法和治疗效果。结果29例感染性眼内炎患者主要致病原因是内眼手术(55.2%)和眼外伤(37.9%);病原体检出率为24.1%,主要致病菌是革兰阳性球菌,以表皮葡萄球菌为多见;7只眼行前房冲洗联合玻璃体腔注药术,6只眼行单纯玻璃体腔注药术,15只眼行玻璃体视网膜联合手术,1只眼行眼内容剜除术,治疗结束共2只眼因感染无法控制而行眼内容剜除术,眼球保存率93.1%,术后平均最佳矫正视力为2.8±1.4,较术前明显提高(1.6±1.0),有统计学意义(t=-6.6,P<0.01)。结论感染性眼内炎常见的致病因素有眼外伤和内眼手术,常见的病原体为革兰阳性球菌,治疗上根据眼内炎的严重程度而采用合适的治疗方案,是控制炎症,挽救视功能的有效措施。     

Ocular toxocariasis in a child: a case report from Kashmir, north India

Toxocariasis is an important zoonotic disease caused by the second stage larva of Toxocara canis or Toxocara cati . The typical clinical syndromes of toxocariasis in humans are visceral and ocular toxocariasis. Ocular toxocariasis may presents as peripheral inflammatory mass, posterior pole granuloma and endophthalmitis. We report a serologically confirmed case of ocular toxocariasis in 12-year-old female. The diagnosis was confirmed by detection of anti- Toxocara antibodies in aqueous and vitreous sample by enzyme-linked immunosorbent assay. We suggest that ophthalmologist in this region should include ocular toxocariasis in differential diagnosis particularly in children and young adults.     

白内障超声乳化术后脓肿型非结核分枝杆菌性眼内炎一例

患者男,48岁,装修工人,因左眼白内障术后眼红、视力下降1周于2011年9月6日来我院就诊,门诊以“左眼眼内炎,人工晶体眼”收入眼科,患者1个月前因“左眼白内障：外伤性？”在我院行白内障超声乳化＋人工晶体植入术,术程顺利.术后18 d（2011年8月28日）患者出现眼红伴视物模糊,怀疑眼内炎,遂行玻璃体抽液培养并玻璃体腔注入万古霉素1 mg,3d后玻璃体抽液培养为非结核分枝杆菌（脓肿型）,因眼部炎症药物控制不佳,病情进一步加重,遂收住院进一步治疗.     

玻璃体切除联合腔内注药治疗晶状体植入术后眼内炎的临床研究

目的探讨玻璃体切除联合腔内注药治疗晶状体植入术后眼内炎的临床效果。方法选择2007年5月至2013年5月成都市第三人民医院眼科收治的行白内障人工晶体植入术后发生眼内炎的患者60例,根据入院先后排序分为两组:对照组29例实施常规腔内注药治疗,观察组31例在对照组的基础上给予玻璃体切除术。对两组患者治疗前后的视力进行统计,评价两组患者的治疗效果,炎症消失时间及并发症发生情况。结果经过治疗,观察组患者视力显著优于对照组,治疗总有效率显著优于对照组,炎症消退时间显著短于对照组,且并发症发生率显著低于对照组,差异均有统计学意义(P<0.05)。结论晶状体植入术后眼内炎是眼科急重症,玻璃体腔内注射联合早期玻璃体切除术对于改善患者预后有重要意义,一旦确诊应立即给予玻璃体腔内注射,并应尽早行玻璃体切除术,以更快地控制炎症,保护患者眼结构和功能。     

Clinical features and microbiology of post-cataract surgery endophthalmitis with and without intracameral moxifloxacin prophylaxis: Endophthalmitis prophylaxis study report 3

Purpose:This study aimed to analyze the clinical presentations, microbiology, and management outcomes of post–cataract surgery endophthalmitis, with and without intracameral moxifloxacin prophylaxis.Methods:This study was designed as a retrospective, consecutive, comparative case series. Records of consecutive cataract surgery from January 1, 2015, till June 30, 2020, were analyzed. The cases that developed endophthalmitis were analyzed. The endophthalmitis cases were divided by their prophylaxis treatment into two groups: with intracameral moxifloxacin (ICM) and without (N-ICM). Inclusion criteria were (1) age ≥ 18 years, (2) cataract surgery with intraocular lens implantation, (3) endophthalmitis within 6 weeks of cataract surgery, and (4) cataract surgery in the institute by any of the three methods—phacoemulsification, manual small incision cataract surgery, and extracapsular cataract extraction.Results:In the study period, 66,967 cataract surgeries were performed; 48.7% (n = 32,649) did not receive ICM. There was no difference between the N-ICM and ICM groups in the incidence of clinical (n = 21, 0.064% and n = 15, 0.043%; P = 0.23) and culture proven (n = 19, 0.033% and n = 11, 0.023%; P = 0.99) endophthalmitis, respectively. Greater number of patients in the N-ICM group had lid edema (76.2% vs. 40%; P = 0.03), corneal edema (71.4% vs. 33.3%; P = 0.03) and lower presenting vision with available correction (logMAR [logarithm of the minimum angle of resolution] 1.26 ± 1.2 vs. logMAR 0.54 ± 0.85; P = 0.02). The final best-corrected visual acuity following treatment was worse in the N-ICM group (logMAR 1.26 ± 1.2 vs. 0.54 ± 0.85; P = 0.02).Conclusion:Endophthalmitis after intracameral moxifloxacin may have relatively milder signs and symptoms and may respond better to treatment.     

硅油填充术在不伴有视网膜脱离外伤性感染性眼内炎的临床应用

目的：观察玻璃体切除联合眼内注药或硅油填充术对眼球穿通伤后合并感染性眼内炎不伴视网膜脱离的疗效。 方法：应用经睫状体平坦部玻璃体切除术，以联合眼内注药或硅油填充术分组治疗30只眼球穿通伤并发感染性眼内炎不伴有视网膜脱离患者，术后予以静脉、结膜下及眼药水途径给予抗感染抗炎治疗。 结果：玻璃体切除术后追踪随访3～12个月，2组30只眼细菌性感染全部控制，术后视力较术前视力有显著性提高，联合眼内注药组19只眼，其中4只眼（21．1％）发生视网膜脱离：联合硅油填充组11只眼，其中术后1只眼（9％）发生视网膜脱离。两组术后并发症发生率均无明显差异（P〉0．05）。 结论：玻璃体切除联合硅油填充术能有效控制炎症，稳定视网膜功能，对一些视网膜情况不佳或炎症难以控制的患者可以考虑术中应用硅油。     

Bacterial endophthalmitis in neonates

Invasive bacterial eye infections in the neonate range from perforating keratitis to panophthalmitis. These infections have gained clinical and therapeutic importance since mortality rates are high and prognosis concerning preservation of vision is poor. Effective antibiotics against the infective agents are now available. Risk factors for developing invasive bacterial eye infections are mainly prematurity and colonisation with Pseudomonas aeruginosa.Abbreviations GBS group B streptococci - SGA small for gestational age     

Endophthalmitis nach Kataraktoperation Disponierende Faktoren, Erreger und Therapie

Zusammenfassung Hintergrund: Die infekti?s bedingte exogene Endophthalmitis stellt eine ernste Komplikation nach Kataraktoperation dar. Sie ist trotz moderner medikament?ser und chirurgischer Behandlungsmethoden oftmals schwer therapierbar. Patienten und Methoden: In einer retrospektiven Studie wurden alle Patienten (n=36) untersucht, die zwischen Januar 1989 und Dezember 1997 an der Universit?ts-Augenklinik Hamburg-Eppendorf (UKE) aufgrund einer Endophthalmitis nach Kataraktextraktion behandelt worden waren. Ergebnisse: Von 36 Patienten wurden der Klinik 29 (80,6%) von au?erhalb zugewiesen. 14 Patienten (38,9%) hatten eine Endophthalmitis nach ambulanter Kataraktextraktion entwickelt. 7 Patienten (19,4%) waren station?r in der Augenklinik UKE operiert worden. Bei 29 der Patienten (80,6%) wurde eine Vitrektomie vorgenommen. Ein Erreger konnte aus 50% der Vorderkammer- bzw. Glask?rperproben isoliert werden, am h?ufigsten Koagulase-negative Staphylokokken (n=4). Zu den pr?disponierenden Faktoren der Endophthalmitis z?hlten Diabetes mellitus (27,8%), perioperativer Glask?rperverlust (19,4%), systemische Kortikosteroidtherapie (13,9%) und Wunddehiszenz (11,1%). Von 27 nachuntersuchten Patienten (75%) erreichten 16 (59,3%) einen Visus von 0,05 oder besser (durchschnittlicher Visus 0,5). Bei 4 Patienten (13,8%) mu?te eine Enukleation vorgenommen werden. Schlussfolgerung: In der vorliegenden Studie konnte bei etwa 60% der Patienten mit einer postoperativen Endophthalmitis das Auge erhalten und eine optische Rehabilitation durch chirurgische Intervention erzielt werden.      

白内障摘出术后急性眼内炎的治疗

目的探讨白内障摘出术后急性眼内炎的病因、临床特点、治疗及预防。方法对15例（15眼）经临床或病理诊断为白内障摘出术后急性眼内炎，进行治疗和疗效分析。结果15例中，13例行玻璃体切除联合注药术，2例行前房冲洗和药物治疗，其中10例术中摘出人工晶状体，所有患眼炎症均被控制；1例眼球萎缩；10例最终视力低于0．1。结论白内障摘出术后急性眼内炎经及时治疗可控制炎症，但视力预后差。预防主要依靠各环节的无菌操作。